I am knowingly participating in a Massage Therapy Session and/or Yoga Class/Session, offered at Studio Zero G.
AntiGravity® Yoga (Aerial Yoga)
Studio Zero G’s BOUNCE®
Massage Therapy Session
During the above listed class/session I will receive information and instructions about Massage Therapy and/or Aerial Yoga and health. I recognize that these actions will require physical exertion, which may be strenuous and cause physical injury. I fully realize and am aware of the potential risks and hazards involved.
I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the above listed class/session. I represent and warrant that I am physically fit and have no medical condition (including pregnancy) which would prevent my full participation in the above listed class/session and the physical exertion within.
In consideration of being permitted in the above listed class/session, I agree to assume full responsibility for any and risks, injuries, or damages, known or unknown which might be incurred as a result of participating in the above listed class/session.
In further consideration of being permitted to participate in the above listed class/session, I knowingly, voluntarily, and expressively waive any claim I may have against Melissa C. Gorham, Robert G. Gorham III, Studio Zero G,LLC, or its staff, instructors, and affiliates* for any injury or damages that I may sustain as a result of participating in the above listed class/session.
I, my heirs or legal representatives, forever release, waive, and discharge negligence or other acts.
Precautions & Requirements
Our Instructors and Therapists have specialized training in their appropriate disciplines and can make recommendations for you to help reach your health and fitness goals, however, we are not physicians. All concerns on health related issues, treatments, medications, and appropriate exercise should be thoroughly discussed with your personal health care provider before partaking in our, Aerial Yoga/Suspension Fitness classes, Massage Therapy sessions, or Salt Therapy sessions.
It is advised to consult your medical professional before beginning ANY new exercise form or Therapy session to see if it is appropriate for you.
- Aerial Yoga is fairly new: your first few classes may be uncomfortable at times as your body adjusts to the pressure. This will subside after a few classes.
- Do not practice on a full stomach.
- Do not practice if you have used alcohol or taken drugs or medications (this includes certain over-the-counter medications)
- Please inform the instructor if you have any injuries, illnesses or are pregnant. See contraindications list below.
- Drink lots of Water throughout the day, this is to rid the body of toxins and lactic acid.
- Keep Practicing! Soreness after a class is completely normal. This is your body awakening. The more you practice, the better you will feel. A consistent yoga practice is recommended to receive the full benefits.
- Lighten your caffeine intake prior to Massage Therapy and/or Aerial Yoga as caffeine can effect the muscular and nervous systems.
- Recent Surgery (esp. shoulder, hip, eyes, back, hands or wrist)
- Heart Disease
- Very High or Low Blood Pressure
- Easy onset Vertigo
- Osteoporosis / Bone Weakness
- Recent Head Injury
- Cerebral Sclerosis
- Propensity for Fainting
- Carpal Tunnel Syndrome
- Severe Arthritis
- Sinusitis or Head Cold
- Hiatal Hernia
- Disc Herniation
- Recent Stroke
- Artificial Joints
- Radiculitis (inflammation of nerve root in spine)
- Severe muscle spasms
- Botox (within 6 hours)
**Notify instructor before class if you have any contraindications so they can help you modify your practice. For certain contraindications additional medical referral forms may be required.**
Massage Therapy Informed Consent
The general benefits of massage, possible massage contraindications, and the treatment procedure have been explained to me. I understand that massage therapy is not a substitute for medical treatment or medications, and that it is recommended that I concurrently work with my primary medical caregiver (physician) for any condition I may have.
I am aware that the massage therapist does NOT diagnose illness or disease, does NOT prescribe medications, and that spinal manipulations are NOT part of massage therapy.
I have informed the massage therapist of all my known physical conditions, medical conditions and medications, and I will keep the massage therapist updated on any changes. I understand that there shall be no liability on the practitioner’s part due to my neglecting to relay any pertinent information.
If I experience any pain or discomfort during the session, I will immediately communicate that to the therapist so the treatment can be adjusted.
Massage Therapy Policies
We require a minimum of a 24 hour cancelation notice for all massage therapy reservations.
1st Missed Appointment: Client will be notified by either phone or email with a reminder of the policy.
2nd Missed Appointment: A Missed Appointment fee of 50% of the reserved session with a minimum of $25 will be billed to the Credit Card on file.
3rd and all Future
Missed Appointments: 100% off the reserved session will be charged to the Credit Card on file.
Attire & Hygiene
- Hair pulled back
- Minimal Make-Up
- No Jewelry
- Minimal Body Lotions or Oils
- No Excessive Perfume
The time you reserve is YOUR time. Use it wisely; if you arrive late your session will be shorter.
Primary AG® & BOUNCE® Instructor:
Melissa C. Gorham
AG® & BOUNCE® Instructors:
Melissa C. Gorham, LMT #:MA60317
I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.